Physicians' Academy for Cardiovascular Education

New meta-analysis on statin use in elderly

Primary Prevention With Statin Therapy in the Elderly: New Meta-Analyses from the Contemporary JUPITER and HOPE-3 Randomized Trials

Ridker PM, Lonn E, Paynter NP, et al. - Circulation. 2017; published online ahead of print

Background

In primary prevention, the role for statin therapy in the elderly is uncertain, according to current cardiovascular (CV) guidelines [1]. Regarding all age categories, rosuvastatin therapy was associated with a 47% risk reduction of nonfatal myocardial infarction (MI), nonfatal stroke or CV death in the primary prevention JUPITER study, and with a 20% reduction of all-cause mortality [2]. Moreover, the HOPE-3 study showed a 24% risk reduction of nonfatal MI, nonfatal stroke or CV death with rosuvastatin and a 7% non-significant reduction of all-cause mortality [3].

In this meta-analysis of JUPITER and HOPE-3 trials, the age-specific outcome data from the elderly subgroups (<65, 65-70 and >70 years) were analysed.

Main results

Conclusion

The meta-analysis of elderly subgroup data in the JUPITER and HOPE-3 studies provide some insights in statin use for the primary prevention of the elderly, however, it also leaves critical questions unanswered that are relevant for clinical practice. For example, benefits should be weighed against the potential for a modest impact on longevity and personal preferences must be taken into account, although benefits are consistent above and below the age of 70.

References

Show references

Find this article online at Circulation